You have indicated to us that your family income for the
2013 calendar year (January 2013-December 2013) will be
reduced compared to your 2012 family income. In order for us
to evaluate this situation and update your application to use
your actual 2013 year family income, your parent(s) must
fill out this form in its entirety. You may also complete this form online
at www.arcadia.edu/finaidforms2013 --> Undergraduate Students --> Income Statement Forms.

Where projected income is requested, please estimate the information as accurately as possible since you will be required
to verify the information at the end of 2013. If you get federal student aid based on incorrect information, you will have to pay
it back. You may also have to pay fines and fees. If your student already received his/her financial aid package, you will be notified
if any adjustment to the package can be made.

Please review your 2012 tax return prior to completing this form. Your projected 2013 income must be less than the income
listed on the tax return to qualify for a reduction in income. When completing this form, please submit a copy of your 2012 federal tax return to
Financial Aid Office if you have not done so already.

Below, please provide a brief description of the
circumstances which caused/will cause the reduced income for
2013. Be specific and provide necessary details. No
re-evaluation will take place if any information is left
incomplete on the form.

Please note if you are selected for Federal Verification for the 2013-2014 year you must provide the University with all requested Verification documentation before this form can be reviewed.

Of the TOTAL AMOUNT listed above for
Wages/Salaries/Tips, please indicate individual amounts for your mother and father. If applicable (include income for both parents, even if only one is experiencing a reduction in income.:

Mother's 2013 earnings

$

Father's 2013 earnings (if applicable)

$

Parent's Estimated Untaxed
Income for Year
(January 1, 2013 through December 31, 2013)